Viral Hepatitis Laboratory, Institut Pasteur de Bangui, PO Box 923, Bangui, Central African Republic.
BMC Infect Dis. 2011 Apr 14;11:93. doi: 10.1186/1471-2334-11-93.
Outbreaks of hepatitis E frequently occur in tropical developing countries during the rainy season due to overflowing drains, short-circuiting of networks of clean water and use of contaminated water from wells. Hepatitis E virus (HEV) infections are usually accompanied by general symptoms of acute liver disease. This study was conducted to define the clinical and epidemiological aspects of the HEV outbreak that occurred in May 2004 in Bangui.
Blood samples were collected from 411 patients aged 1-87 years, most of whom presented with jaundice, asthenia or signs of uncomplicated malaria, for a transversal study from June 2004 to September 2005. Patients were recruited at 11 health care centres, including two referral hospitals, after they had given informed consent. The diagnosis of HEV was made with a commercial ELISA test to detect IgM and/or IgG antibodies. HEV RNA was amplified by RT-PCR to confirm the presence of the viral genome.
The most frequent clinical signs found were jaundice (93.4%), vomiting (50.7%), hepatalgia (47.4%), hepatomegaly (30.9%) and asthenia (26.8%), which are the general clinical signs of hepatic disease. Acute hepatitis E was found in 213 patients (51.8%) who were positive for HEV IgM antibodies. The IgG anti-HEV seroprevalence during this outbreak was high (79.5%). The age group 18-34 years was more frequently infected (91.2%) than those aged 1-17 (78.0%) or over 34 (64.9%) (p < 10-6). RT-PCR performed on 127 sera from the 213 IgM-HEV-positive patients was amplified, and the presence of the viral genome was found in 65 samples.
Although no specific clinical signs exist for hepatitis E infection, people presenting with jaundice, vomiting, hepatalgia, asthenia, hepatomegaly or distended abdomen with no signs of uncomplicated malaria in tropical developing countries should be sent to a laboratory for testing for hepatitis E.
由于排水沟溢出、清洁水网络短路以及使用受污染的井水，戊型肝炎病毒（HEV）在热带发展中国家的雨季经常爆发。HEV 感染通常伴有急性肝病的一般症状。本研究旨在定义 2004 年 5 月在班吉发生的戊型肝炎爆发的临床和流行病学特征。
从 2004 年 6 月至 2005 年 9 月，对 411 名年龄在 1-87 岁之间的患者进行了横断面研究，这些患者多数表现为黄疸、乏力或无并发症疟疾的体征，在 11 个医疗中心（包括 2 家转诊医院）采集了血样。在患者知情同意后，对他们进行了招募。使用商业 ELISA 试验检测 IgM 和/或 IgG 抗体来诊断 HEV。通过 RT-PCR 扩增 HEV RNA 以确认病毒基因组的存在。
最常见的临床体征是黄疸（93.4%）、呕吐（50.7%）、肝区疼痛（47.4%）、肝肿大（30.9%）和乏力（26.8%），这些都是肝脏疾病的一般临床体征。213 例 HEV IgM 抗体阳性患者被诊断为急性戊型肝炎。此次爆发期间，IgG 抗-HEV 血清阳性率很高（79.5%）。18-34 岁年龄组的感染率（91.2%）高于 1-17 岁（78.0%）或 34 岁以上（64.9%）（p<10-6）。对 213 例 IgM-HEV 阳性患者的 127 份血清进行 RT-PCR 检测，在 65 份样本中扩增出了病毒基因组。
尽管戊型肝炎感染没有特定的临床体征，但在热带发展中国家，如果出现黄疸、呕吐、肝区疼痛、乏力、肝肿大或腹部膨隆但无无并发症疟疾的体征，应将患者送往实验室检测戊型肝炎。
